Researchers from the London School of Hygiene and Tropical Medicine has suggested that half of TB transmission occurs before individuals will even access care under existing TB care policies.
This investigation suggests that one in two individuals with subclinical TB, who are likely infectious but are not aware of symptoms, will not progress to disease severe enough to seek care.
Research presented on day three of The International Union Against TB and Lung Disease’s World Conference on Lung Health revealed how new insights into TB highlight the weakness of current policies designed to eradicate the disease, where individuals need to report symptoms in a clinic before receiving care.
The amount of transmission missed was reduced to a third if the study assumed a lower relative infectiousness for subclinical TB.
The study, which used a deterministic modelling framework based on 1,000 cohorts of 10,000 individuals, found that 93.5% of TB-infected individuals will not contribute to transmission within 10 years of MTB infection.
Prof Rein Houben, Principal Investigator of the European Research Council funded project said: “The TB community has suspected for a while that current TB policies are not enough to drive TB down. Our work maximised the value of old and new data using mathematical models, and while still in development our results show just how much transmission is missed, and how many individuals with likely infectious TB will not receive care.”
TB CASES NEED TO BE ACTIVELY SOUGHT OUT TO REDUCE TRANSMISSION
At The Union World Conference, tuberculosis experts also presented how active case finding (ACF) could reduce the 52,000 TB cases in Cambodia, of which nearly 50% go undiagnosed. With this figure often higher in minority and hard-to-reach communities, scientists stressed the importance of focusing ACF efforts in these areas.
Researchers conducted mobile case findings across 26 remote communities, which resulted in over 8,000 patients being screened. More than 5% of these people were diagnosed with TB – with 321 TB patients receiving treatment that they would not have otherwise, constituting an increased detection of 370%.
These results demonstrated the positive impact of adopting a policy of ACF in reducing transmission of TB within the community, coupled with widening invaluable access to diagnostic facilities.
WORLD HEALTH ORGANISATION SHARES PROJECT FOR ENDING CHIILDHOOD TB
The urgency of researchers’ findings was reflected by the launch of the World Health Organisation’s roadmap to prevent and treat TB in children and adolescents. The roadmap outlines an ambitious five-year plan with 10 key actions to improve the prevention, treatment, and care of TB in young people.
Children and adolescents experience a disproportionate burden of TB. The WHO recently released its Global Tuberculosis Report, which highlighted that an estimated 1.25 million children and young adolescents fell ill with TB in 2022, making up 12% of the global TB burden.
“It is unacceptable that hundreds and thousands of children and adolescents worldwide still do not have access to life-saving TB prevention, treatment and care”, said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.
“The new Roadmap lays the groundwork for much needed actions over the next five years building on commitments made by world leaders at the 2023 UN High Level Meeting on TB, to close gaps in access to care and safeguard the rights of children and adolescents.”
SMOKING ACCELERATES CELL AGEING IN THE YOUNG
Pakistani researchers, led by Uzair Abbas from Aga Khan University, reported an “alarming” discovery that chemical compounds in cigarette smoke also accelerate cell ageing, with this process occurring more quickly in younger smokers than those who are older.
The impact of smoking on lung health contributes globally to about 6 million deaths per year worldwide. Beside the impact of smoking on lung health, this study suggests that younger smokers are more susceptible to changes in their cell physiology, potentially leaving them at a greater risk of developing poor oral and lung health.
LONGER-TERM IMPACTS ON FERTILITY OF TB DIAGNOSES IN THE YOUNG REVEALED
Additional research conducted by New Delhi-based researcher Dr Sangeeta Sharma from India’s National Institute of Tuberculosis and Respiratory Diseases exposed the shocking long-term impacts that TB can wreak in young patients through research into the effects of pulmonary TB (PTB) in adolescent girls. PTB is a common form of TB which involves an infection of the lungs.
In adolescent girls, the disease can cause menstrual dysfunction and the formation of tubo-ovarian masses, which can lead to infertility later in life.
The study examined 280 adolescent girls with PTB, with a shocking 15% of these found to have TB-related genital findings, and 12% to have tubo-ovarian masses. Patients with severe forms of the disease including drug resistant cases were affected more severely. However, early diagnosis and timely treatment could prevent permanent damage, Dr Sharma found.
As a global disease suffered by millions across the world, these potentially devastating longer-term effects of a PTB infection hammer home the vital importance of securing timely diagnosis and treatment. These scientific discoveries come at a crucial moment for the TB community after world leaders pledged funding and agreed targets for the next five years towards ending the global TB epidemic at UN High-Level meeting on health in New York in September.
The Union World Conference on Lung Health is convened by the International Union Against Tuberculosis and Lung Disease, the world’s first global health organisation, committed to eradicating tuberculosis and lung disease.
Professor Guy B. Marks, President and (Interim) Executive Director, International Union Against Tuberculosis and Lung Disease (The Union) said: “The presentations given today at The Union World Conference on Lung Health have shown that the time for the global TB community to act is now. We must continue to keep broadening access to diagnostic and treatment of tuberculosis. Through further research, innovation, and education, we can ensure that no-one is left behind as we strive towards a world free of tuberculosis and lung disease.”
The Union
Established in 1920 as the world’s first global health organisation, the International Union Against Tuberculosis and Lung Disease is committed to eradicating tuberculosis and lung disease, leading to a healthier world for all. Its members, staff, and consultants work in more than 140 countries globally.
The Union aims to improve the world’s lung health by prioritising prevention and care, through bringing together clinicians, patients, survivors, policy makers, scientists, and managers to disseminate and implement knowledge in practice. The Union’s work is exemplified by its core values of quality, transparency, accountability, respect, and independence.
